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Evolution of Healthcare Information Systems

Introduction

A hospital information system is a management system which includes electronic financial data reporting, administration of hospitals, health care, patient data, staff billing as well as maintenance of the infrastructure and the equipments for smooth operation and auditing. Early information management systems were applied in maintaining data for patients, stock control, billing and the financial accounts of hospitals. There were few computers in use unlike today when hospitals have many computers to keep database and necessitate data communication that are accessible via Ethernet, internet or local area network to different administrators who any other personnel who has a password for access, card for access or is authorized by database administrator.

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Kaplan (1988) proposes that information systems may be centralized with connections to satellite systems which are independent and reliable. Hospital billing and financial departments can be centralized to work for other associated hospitals while maintenance of patients’ records is connected to exchange data with laboratory information system in other locations and departments like food and nutrition, nursing department, theater care centers like Intensive Care Unit and High Dependence Unit. Information systems can be decentralized by the use of a computer program for hospitals which enables workstations and servers (see figure 2) to be located in different places and thus increasing efficiency of operations. Information systems for hospital can be patient oriented to handle patient information on scheduling and attendance history or business oriented to handle financial transactions such as the payment of salary to staff, purchases and sales in the hospital.

Thompson and Handelman (1978) have suggested that terminals can be connected to Computers in a wide area (Wide Area Network-WAN) within the management system. They are connected to a server or a main frame computer so as to access data that is required. A work station is an information system that has computers that can work on their own and may be connected to other computers in the network that can be composed of modern personal computers which are mostly used today so long as configuration settings are not conflicting. According to asiahhm (2006), earlier hospitals used terminals (see figure 1: Frost and Sullivan report) and centralized information systems but currently hospitals use the decentralized information systems which enable automatic data processing. The change in the use of information systems was influenced by internal factors which include the hospital administrators driven by the ambition to update their system with modern automated computer systems and the medical staffs increase for demand of modern equipment and computers that have higher data storage capabilities as well as capable of higher speeds of the computer processors backed up by need for a higher Read Only memory (ROM) in order to increase virtual memory of the computers. External factors like the modernization, discovery and improvement of software systems have also led to change. There has been a new technology for distributed systems that has led to updated soft wares and automated computers rendering the old system obsolete.

Features of hospital information systems

Friedman and Wyatt (1997) observes that a nursing information system is a subset of hospital information systems which handles care plans with charting functions and handles order entry for the patients. This information system is also involved in discharge planning and determination of how severe a patient’s condition may be. It also makes assessment to the nurses and helps in educating the patients. It displays the patients’ data on graphs and makes pathways for critical case management and facilitates sharing of information with the other departments. The nursing information system also manages and controls degree of use of the administered medicine to patients.

An administration information system controls the functions of the entire organization by helping in decision making and overhead planning for purchase of hard wares such as automated computers, software and maintenance of the infrastructure. This system has information technology experts who are involved in programming. Shari (1987) proposes that maintenance for hospitals information systems involves subsequent programming activities to rectify mistakes in the system termed as debugging. They also help the hospitals information system to respond to government policy and abide by protocols and legislation with regard to new medical programs and reporting requirements. Laboratory network (2008) indicates that laboratory information system is concerned with keeping and maintaining data on research and diagnosis of diseases and infections as well as research and development.

Osgood (1984) argues that a radiology information system is maintained to help in storage, manipulation and retrieval of data in the radiology department. It also helps in the scheduling of the patients appointments for the department. The picture archiving information system helps in storing pictures of the patients in the archives. It communicates data to the other information systems whenever it is needed. The pharmacy information system is used for billing and keeping a database of drugs that are bought, sold and administered to patients in the hospital. It works in conjunction with the inventory and billing information system to get data from the other systems and share its own data with them. The hospitals Order entry assessment and adequate results reporting are also maintained by the pharmacy information system.

The hospital information systems of today

Williams (1990:30-32) indicates that hospital information systems of today are different in that they use modern automated computers that can work independently and which also connect with the other departments. Bates (2003) argues that access of information is made possible through Ethernet, local area networks, wide area network and the internet. Health data mining is also made possible. This makes it possible for the assessment of data between different systems unlike the earlier days when concept of computer networking was not realized and its potential not fully utilized. The increased use of integrated wide automated data processing system enables data to be accessed by the other systems from its hosting system. This has increased efficiency unlike the earlier systems where data had to be printed so that it can be distributed to the other systems.

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Bates (2003) argues that use of new hardware and software in the hospital information system by selection of computers which meet departmental needs has enabled the system to function fast as opposed to bulk paper work that characterized the old health information system. Today the hospital information systems enable numerous practices that include calculation, word processing and database management unlike the case with terminal based systems that were slow and unreliable.

Healthcare management system, Inc. (2008) indicate that many computers in use today that are put in different locations of every department thus helping in fast operations of the hospital and its affiliated departments. The staff has computer access in the hospital at its required place. Hospitals have computers in the staff offices, the wards and also in the adjacent rooms close to the patients ward. This helps the nursing information system to work efficiently and in timely manner. In the earlier systems, there were few computers in the hospital systems and response of the staff was made slow. An electronic data can be sent in form of an email or memo from one department to another. This has enhanced electronic data communication in the hospital information systems thus easing operations. Bates (2003) suggests that a physician can connect to the server of the information system and access data from the laboratory information system while at home or distant places. This has increased the flexibility of working and enhanced data communication and database management in the system and improved efficiency of data retrieval during research.

Conclusion

Healthcare and hospital information systems have greatly changed in the past twenty years and this has been as a result of improvement of information technology. Hospitals today have updated databases where students, members of public, researchers and other health personnel can carry out health data mining. Different sub-systems and systems of health are linked through Ethernet, local area networks, wide area networks, via satellite and internet. Healthcare centers and hospitals have greatly improved their efficiency on operations, performance of staff and the control of their operations. Data communication, management and hospital’s corporate image has also been enhanced by improvement of information technology in the Medicare institutions.

The main frame 
Figure 1: The main frame 
Decentralized hospital information system
Figure 2: Decentralized hospital information system

Bibliography

Asiahhm. (2006). Hospital information systems. Web.

Bates, D. (2003). Computer physician order entry. Washington, DC: The leapfrog group.

Friedman, C. and Wyatt, J. (1997) Evaluating Methods in Medical Informatics: Springer-Verlag

Healthcare management Systems,Inc. (2008). Perot systems successfully implemets Hospital information systems in Abu Dhabi. Web.

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Kaplan, B. (1988). Development and Acceptance of medical Information Systems: A Historical Overview. J. Health Human Resource Admin, Vol. 11 pp. 9-29

Laboratory network. (2008). florida hopsital, lab and nursing staffs enhance patients safety with Sunquest collection manager. Web.

Osgood, J. W. (1984). The hospital Systems Industry: Boston, MA. Alex Brown and Sons

See Shari L. (1987). Software Engineering: The production of quality Software, New York. MacMillan Publishing Co. pp. 373-406

Thompson, W. and Handelman, I. (1978): Health, Data and Information Management. London, Butterworth.

Williams, B. (1990). How to do an ROI (Return on investment). HealthCare information , Vol 7 (ISS 2), pp. 30-32.

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